```

[Federal Register Volume 76, Number 19 (Friday, January 28, 2011)]
[Notices]
[Page 5179]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-1865]

[[Page 5179]]

-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-10112 and CMS-287-05]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS) is publishing the following summary of proposed 
collections for public comment. Interested persons are invited to send 
comments regarding this burden estimate or any other aspect of this 
collection of information, including any of the following subjects: (1) 
The necessity and utility of the proposed information collection for 
the proper performance of the agency's functions; (2) the accuracy of 
the estimated burden; (3) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (4) the use of 
automated collection techniques or other forms of information 
technology to minimize the information collection burden.
    1. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Phone Surveys of Products and Services for Medicare Payment Validation 
and Supporting Regulations in 42 CFR 405.502. Use: The phone surveys of 
products and services for Medicare payment validation and supporting 
regulations in 42 CFR 405.502 will be used to identify specific 
products/services provided to Medicare beneficiaries and the costs 
associated with the provision of those products/services. The 
information collected will be used to validate the Medicare payment 
amounts for those products/services and institute revisions of payment 
amounts where necessary. The respondents will be the companies that 
have provided the product/service under review to Medicare 
beneficiaries. Form Number: CMS-10112 (OMB 0938-0939); 
Frequency: Occasionally; Affected Public: Private sector--business or 
other for-profit; Number of Respondents: 4,000; Total Annual Responses: 
4,000; Total Annual Hours: 16,000. (For policy questions regarding this 
collection contact Michael Rich at 410-786-6856. For all other issues 
call 410-786-1326.)
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Chain Home Office Cost Statement and supporting Regulations in 42 CFR 
413.17 and 413.20; Use: The Form CMS-287-05 is filed annually by Chain 
Home Offices to report the information necessary for the determination 
of Medicare reimbursement to components of chain organizations. 
However, where providers are components of chain organizations, 
information included in the chain home office cost statement is in 
addition to that included in the provider cost report and is needed to 
determine whether payments are appropriate. Form Number: CMS-287-05 
(OMB 0938-0202); Frequency: Yearly; Affected Public: Business 
or other for-profit and not-for-profit institutions; Number of 
Respondents: 1,541; Total Annual Responses: 1,541; Total Annual Hours: 
718,106.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web Site at http://www.cms.hhs.gov/PaperworkReductionActof1995, or E-
mail your request, including your address, phone number, OMB number, 
and CMS document identifier, to Paperwork@cms.hhs.gov, or call the 
Reports Clearance Office on (410) 786-1326.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by March 29, 2011:
    1. Electronically. You may submit your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Document Identifier/OMB 
Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.

Martique Jones,
Director, Regulations Development Division-B, Office of Strategic 
Operations and Regulatory Affairs.
[FR Doc. 2011-1865 Filed 1-27-11; 8:45 am]
BILLING CODE 4120-01-P
```